"Treatment of Diabetics "

About: City Hospital campus / Diabetic medicine Queen's Medical Centre / Diabetic medicine

(as the patient),

I am an Insulin Dependent Diabetic (IDD type 2) who had a cardiac problem earlier in 2009, and therefore I take a lot of medication, in addition to Insulin (60 units/day) and Metformin.

I went in to NUHT Queens Med last month to have a "Bilateral Superficial Femoral Angioplasty", and they duly put tubes into the arteries of both legs and expanded the blockages therein. That bit proved to be a very neat job & I was allowed to escape at 10 last night - though I am required to rest today.

However, I felt the treatment of me as a diabetic was not good. At the pre-exam last week it was all discussed, & all agreed. I arrived and the nurse who received me was unaware I was IDD but took it well & checked that I had stopped metformin etc & that I had brought my medication. Once on the ward I felt no one knew I was diabetic, I saw nothing was put on my records, which were rarely checked. Every nurse I came across had to be told separately - but I felt it meant little to most of them.

The worst was the staff nurse with the drugs trolley. After giving me a long lecture about keeping off Metformin for 2 days (it reacts with the blood dye they use) she was surprised to discover I was diabetic. I felt she reacted badly to me having my own insulin with me and did not want me to self medicate.

But she then declared to me she could not give it as it was not on my medication card (a failing at reception perhaps). Eventually with what I thought was bad grace, she agreed I could inject. I was flat on my back (compulsory after an angioplasty) so could not eat the food brought round and a sandwich had to be sent for. When some food (I thought was very poor) eventually arrived (18:00 - after nothing by mouth from 08:00) I set to inject. The nurse who brought the food objected and said she would do it - but a senior nurse told her she must not & ran off to fetch Staff nurse.

Meantime I quickly made a stab in the dark (you cannot see the injection site if you are flat on your back). Staff nurse arrived about an hour later and told me off. I did not see that nurse again once she went off. I could have used a paracetemol by then.

At theatre they did start checking my glucose, but readings of 12, 14, 14 (getting dangerously high) seemed to arouse no interest and after that they stopped taking it. On the ward I had to request they measure my blood glucose - not on my records apparently. This contrasts with my treatment when I had my cardiac angioplasty at the Park Hospital in April - when my glucose was held firmly between 6 & 7 for 24 hours with an insulin drip and a glucose drip. I wonder whether this is too expensive for the NHS, or whether they do not understand.

I would like to see the staff at Queens get their act together. It seems to me that the problem is systemic. My records were not consulted properly, and even when staff were made aware that I was IDD it seemed to make no difference to their actions. Taken overall, I feel there is a conflict between the desire of the senior nursing staff to be in control of medication, and the need for patients to take their medication for all their conditions - not just the ones related to this admission.

I think it is also essential the Insulin Dependent Diabetics are given proper attention. We are under stress, which is likely to cause our glucose reading to go haywire. I think readings as high as 14 must not be ignored, they can seriously retard the healing process. I believe 10 hours without food is not reasonable.

I can look after myself but I feel they did not make it easy. Would that staff nurse have really refused to allow an insulin injection?

Apart from this problem the nursing staff were doing a super job, especially with two older men who needed a great deal of help.

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Response from Helen Limb, Patient and Public Involvement Manager, NHS Rushcliffe Clinical Commissioning Group

Thank you for taking the time to give us your comments. We have passed them on to the hospital, where they take your comments very seriously. However, without further details it is difficult for them to investigate fully and take steps to act on the issues. If you would be happy to share some further information, please contact their PALS team either by by email or call 0800 183 0204. Best wishes
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